MAGIC in practice: Experience of peri-operative ECF/X chemotherapy in gastro-esophageal adenocarcinomas

Background The MAGIC trial demonstrated the perioperative regimen of Epirubicin (E), Cisplatin (C) and 5‐Fluorouracil (F) to have an overall survival benefit for patients with gastro‐esophageal adenocarcinomas. We present our experience of the peri‐operative regimen of ECF/ECX(X = Capecitabine) in o...

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Published in:	Journal of surgical oncology Vol. 106; no. 6; pp. 748 - 752
Main Authors:	Reece-Smith, A.M., Saha, S., Cunnell, M.L., Hameed, K., Bessell, E.M., Duffy, J.P., Madhusudan, S., Parsons, S.L.
Format:	Journal Article
Language:	English
Published:	Hoboken Wiley Subscription Services, Inc., A Wiley Company 01-11-2012 Wiley Subscription Services, Inc
Subjects:	Adenocarcinoma - drug therapy Adenocarcinoma - mortality Adenocarcinoma - pathology Adenocarcinoma - surgery Adult Aged Antineoplastic Combined Chemotherapy Protocols - therapeutic use ECF Esophageal Neoplasms - drug therapy Esophageal Neoplasms - mortality Esophageal Neoplasms - pathology Esophageal Neoplasms - surgery Esophagogastric Junction Female gastro-esophageal adenocarcinoma Humans MAGIC trial Male Middle Aged neoadjuvant chemotherapy Retrospective Studies survival
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Summary:	Background The MAGIC trial demonstrated the perioperative regimen of Epirubicin (E), Cisplatin (C) and 5‐Fluorouracil (F) to have an overall survival benefit for patients with gastro‐esophageal adenocarcinomas. We present our experience of the peri‐operative regimen of ECF/ECX(X = Capecitabine) in operable gastro‐esophageal adenocarcinoma. Methods Analysis of retrospective data of patients treated with MAGIC style therapy between May 2006 and August 2008 with potentially operable gastro‐esophageal adenocarcinoma. Results One hundred patients underwent peri‐operative chemotherapy according to the MAGIC protocol. Median age was 66 years, with 39% above the age of 70 years. The tumours were evenly distributed between the lower esophagus, gastro‐esophageal junction and stomach. Seventy‐nine percent completed all pre‐operative cycles of chemotherapy and 81% proceeded to surgery, whilst 24% did not receive curative surgery. The median survival on an intention to treat analysis is 31.7 months from diagnosis. The median survival of patients who underwent resection has not yet been reached after a median follow‐up of 41.4 months. Conclusion Our patient population is older than the patients in the MAGIC trial (age 66 years vs. 62 years) with a much higher proportion of esophageal and GEJ tumours. Overall, curative resection rate was comparable to the MAGIC trial. Overall survival is superior to that found in the MAGIC trial. J. Surg. Oncol. 2012; 106:748–752. © 2012 Wiley Periodicals, Inc.
Bibliography:	ArticleID:JSO23187 The authors declare no conflict of interest. ark:/67375/WNG-H02R1Z7C-9 istex:B9803AD9FB605F781D55D28F70E6BE8141B8AAC1 ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23
ISSN:	0022-4790 1096-9098
DOI:	10.1002/jso.23187